Individual
WADE BROR CLAUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
7411 METZGER AVE UNIT B, JBER, AK 99506-2022
(907) 330-9779
Mailing address
7411 METZGER AVE UNIT B, JBER, AK 99506
(907) 330-9779
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
EMT530361
FL
164W00000X
Licensed Practical Nurse
Primary
6820
AK
164W00000X
Licensed Practical Nurse
PN5199765
FL
Other
Enumeration date
03/13/2012
Last updated
03/13/2012
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